08-1830 (MECH)P.O. BOX 1504 ,- VOICE 760 777-70.12
78-495 CALLE TAMPICO FAX (760) 777-7011 '
LA QUINTA, CALIFORNIA 92,253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777 -7153 -
BUILDING PERMIT
Date: 11/06/08 '
Application Number: , ',_'08700001830 Owner: "
Property, Address: 48643 VISTA TIERRA DRACKETT GORDON
APN: 646-081-022- - - 48643 VISTA TIERRA
''. Application description.MECHANICAL _ LA QUINTA, CA 92253 '.
Property Zoning: LOW DENSITY RESIDENTIAL x (760) 771-3898 -
Application valuation: 4000
'Contractor. rJ r
Applicant- Architect or
Engineer: BEST IN THE WEST d
255 N. EL CIE, C 1 2
C .PALM SPRINGS, CA 2
.(760)322-0202 o
Lic - No - . 826714 !!!/ fj ?QOd
--------------------------- ----------,----------------------=------------FiN�N� aTA-----------
--- - ,
CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATIhereby affirm under penalty of perjur
g�S�D
nsed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:Section 70001 of Division It of the B in e 1 ionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided -
License Class: C20 -C38 License No.: 826714 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
r issued.
Date% P- 6 J Contractor: ` I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workerscompensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier STATE FUND Policy Number 0023975-2007
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in.the performanc _ work for which this permit is issued, I shall not employ any -
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner s to bec a subject to the workers' compensation laws of California, "
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if o d becom ubject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the or C o hwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: - Date: � Applicant: --
1 - 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL'. PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. ,
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed - 1 :,- Each person upon whose behalf thisapplicationis made, each person at whose request and for
pursuant to the Contractors' State License.Law.). • whose benefit work is performed under or pursuant to any permit issued as a result of this application, ,
1 _ 1 I am exempt under Sec. BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
- performed under or following issuance of this permit.
Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced -
- within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject -
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending, agency for the performance of the I certify that I have read this application and state that the in ti is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).- - city and county ordinances. and state laws relating to buil n s , and hereby authorize'representatives
• - of this county to enter upon the above-mentioned pro i p •rposes.
Lender's Name: - -
f - - - - - -� Date:/ %� .& Signature (Applicant or Agent).
Lender's Address: - - - - -
j'LQPERMIT
.'-Application Number-*. 08-00001830
Permit MECHANICAL
' Additional desc
Permit Fee 24.0,0 Plan Check Fee..
6:00:• e
Issue Date Valuation
0
- Expiration Date 5/05/09
Qty Unit Charge Per.
Extension
BASE FEE
15.00
' 1.00 :9.0000 EA MECH B/C <=3HP/100K BTU
~ Special Notes and Comments
CONDENSER & COIL CHANGE OUT 5.TON 14
SEER UNIT. '
Fee summary - Charged Paid Credited
Due
Permit Fee Total 24.00 .00 .00
24.00
Plan Check Total 6.00 .00 .00'
_ 6.00
Grand Total 30.00 -.00 .00
-30.00
LQPERMIT
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-CERTIFICATE OF COMPLIANCE: RESIDENTIAL
(Page l',of 1),.: C&lk-A'j
Project Title•L Date
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duct systems that are extended, which are constructed, insulated or sealed with asbestos?
3
Documentation u or
Telephone -
Plan Check / Dated {4�7^
FSt7`
-jh.c7 3Z oz.c)Z
CF -6R pages 3 and 5 of 12
; Date' ”.
Eield Clieck�/
�tif
❑'
Method (Prescriptive — HVAC and/
Duct System Alteration 152(b)IC, D, E)
Climate Zone
LMnforcementAgency'Use �ny-0�Compliance
nor
- § and
❑
High EER . ;
CF -6R pages 3 and 8. of 12
CF4R page 5 of 8 ,.
HVAC SYSTEMS T
Heating Equipment Type Minimum Distribution Type Duct or Piping
r and Capacity (furnace, heat' Efficiency, and LocationThermostat Type,'
(ducts, . Insulation
pump, boiler, etc. (AFUE or HSPF) attic, etc. r R -Value (setback)
;
Configuration
, (split or package)
Exceptions
1
HERS Rater Forms (trappticabte)
Duct systems that are documented to have been previously sealed as confirmed through field verification,and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
E3Existing
Cooling Equipment Type•Minimum DuctLocation Duct Insulation . ThertnostatType Configuration
and Capacity (A/C, heat i Efficiency (attic etc.) R -Value j (setback)
um ,'ev coolin (SEER or EER) ) (split or package)
SEALED DUCTS, REFRIGERANT CHARGE (TXV) AND EER
Before the permit can be finalized, a'signed CF -6R Form and CFVR Form must be provided to the building department for any of the.
following compliance requirements that are ✓ :1 -1
om liance Requirements -
led -Ducts (Climate Zones 2 and 9-16) - Installer testing and HERS Rater field verification required
TXV (Climate Zones 2 and 8-15);- Installer testing and HERS Rater field verification required'
❑ Refrigerant Charge (Climate Zones 2 and 8-15),- Installer testing and HERS Rater field. verification required'
0. ALTERNTAVE to Duct Testing:.High. EER as indicated in'Table 8-3 of the Residential Compliance Manual (SEE Table 8-3 for ,
additional requirements and available Com liance O tions) - Installer testing and HERS Rater field verification required.
The prescriptive requirement for either a refrigerant charge or a TXV does not apply to packaged units...' 4"
EXCEPTIONS' 4t r?
If any of the following three excetitions'are V,the duct s v stem is exem tfrom sealed ducts ; Y{
s-
#
✓-
Exceptions
1
HERS Rater Forms (trappticabte)
Duct systems that are documented to have been previously sealed as confirmed through field verification,and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
E3Existing
duct systems that are extended, which are constructed, insulated or sealed with asbestos?
3
❑
Duct systems with less than 401inear feet of ducts in unconditioned space.
rp-. '•<
Duct alterations are exempt from duct sealing ONLY if they meet Exception 2 above.' `
� CI
SPEAL FEATURES REQUIRING HERS RATING VERIFICATION r r
A ✓ indicates which compliance reuirements are art of this ro•ect and need HERS rater verification
✓
ompliance Requirements
Installer Forms prappricable)
HERS Rater Forms (trappticabte)
-
Duct Sealing
CF76R pages 3 and 4 of 12
CF -4R page,I of 8
.
'Thermostatic Expansion Valve (TXV).
CF -6R pages 3 and 5 of 12
'CF -4R page 3 of 8
CF
❑'
Refrigerant Charge:
-6R pages 3, 5 and 6 of.12
CF -4R pages 3 and 4 of 8
❑
High EER . ;
CF -6R pages 3 and 8. of 12
CF4R page 5 of 8 ,.
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City of La Quints '
- • ., .
" Building•8i Safety Division '
P.O. Box 1504,-78=495 Calle Tampico
1:i Quinta,-CA 92253 - (760) 777-7012
Permlt Application and Tracking Sheet
Permit # /�
\�
C-Building
Project Address: (/3 T rX
Owner's Name Plot —
A. P. Number:
Address: 3 M 71 �-
Legal Description: -
City, ST `
Zip: �zz53
Contractor:�5� , �ti £ • �1�i$�J—
Telephone: '7 —% 3`'
Address: Z ti ��!?� r
Project Description:
City, ST, Zip 9
Telephone: 76LI -3 7,Z D-ZO Z-
m�csar.��urre�x
State Lic. # : / '
City Lic. #:
S
Arch.; Engr., Designer:
Address: h
,.
City, ST, Zip: , t
Telephone:
Construction Type: Dccupancy: •
State -Lic. #:
Project type (circle one): New - Adc'n Alter Repair , Demo
n: ;
Name of Contact Perso7, ,
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: -3z --z— cZA Z
Estimated Value of Project: oe
u APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cheek Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
,•
Energy Calcs.
Plans picked up;
Construcdon
M
Flood plain plan
Plans resubmitted'
Mechanical
Grading.plan
2nd Review, ready for corrections/issue
Electrical '
Subcontactor List
Called Contact Person -
Plumbin€:
,
Grant Deed
'Plans picked up
S.M.I.
H.O.A. Approval '
Plans resubmitted ^ `
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
J Date of permit issue
'
School Fees
+
TotalPe-mit Fees